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Discussion

Right track?

Hey Everybody,

My ultimate goal is to become a flight nurse. Right out of highschool I recieved my CNA and EMT-B certification. I currently work at a level II trauma center, 250 bed hospital in the float-pool, where I feel like I have been able to network myself pretty well.

I am currently enrolled at our university for a BSN and minor is business. I have a couple more prereqs to go before I start my clinical stuff. I decided to enroll part-time and take an 18 month paramedic program this year (most people think I am crazy... I think I am crazy).

There is a local university here that has a Medic to RN bridge course, where you challenge your first clinical rotations in nursing. It is only a Associates degree though. My first question is- stay in the bachelors or take the associates degree and bridge later?

My second question is, is there anybody out there that works part-time ICU nurse and part-time medic?

My third is CCRN vs. CCEMT, is it worth pursing both, does one weigh in more than the other.

I live in Maine if anyone was wondering, and am 20 y/o.

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    • Featured Replies

    Do you want to be a Paramedic or a Flight RN? Or a jack of all and master at nothing? Focus on something and be good at it before moving to the next.

    ADN, Paramedic Cert, then maybe BSN is not focusing especially if you want to get some experience in there.

    Why would you even want to be a Flight RN if you believe they can not do much or do "critical thinking" or know anything about safety?

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    • Author

    I want to do both. Jack of all trades. I think itd be best to agree to disagree, because I see an RN and EMT-P certification to be very equivelant. I dont down play anything. I know both professions are totally different. One is long term, one is short term. Like I said, in my state they are both equivelant, and a paramedic needs to be able to everything an RN can and vice versa.

    I do believe in education too. I believe in being well rounded too. My goal is to make myself the most competitive applicant. So if I can be competant as both a medic and a nurse it can only benefit me.

    I can see where your dislike for medics are on your previous post. I understand it.

    I believe your answer to my question is stick with the BSN program. CCRN over CCEMT. And I am assuming you are not a medic either so you cannot answer my second question. Thank you for chatting with me :-)

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    I want to do both. Jack of all trades. I think itd be best to agree to disagree, because I see an RN and EMT-P certification to be very equivelant. I dont down play anything. I know both professions are totally different. One is long term, one is short term. Like I said, in my state they are both equivelant, and a paramedic needs to be able to everything an RN can and vice versa.

    I do believe in education too. I believe in being well rounded too. My goal is to make myself the most competitive applicant. So if I can be competant as both a medic and a nurse it can only benefit me.

    I can see where your dislike for medics are on your previous post. I understand it.

    I believe your answer to my question is stick with the BSN program. CCRN over CCEMT. And I am assuming you are not a medic either so you cannot answer my second question. Thank you for chatting with me :-)

    Telling you what you don't want to hear is not a dislike for Paramedics. Like many who started in EMS and then went on, we learned the difference between a tech certificate (Paramedic, LPN) and a degreed profession (RN, RT, RRT, SLP, OT, PT etc). Your state requires about the same number of hours for the Paramedic cert in total as some RN and other allied health program require just for clinicals. The minimum education requirements are not equivalent. Looking also at the scope of practice for Paramedics in Maine, it is the same as most states which is still very limited. Do not criticize the Paramedics who have gone into nursing to actually do critical care at the bedside and on transport. You too could be seen as a "Paramedic hater" by those giving you the street smarts advice when you get your RN and see the difference.

    Maybe you should see what RNs actually do in an ICU before making your decision. I would suggest you go to a hospital which has a little better rating. Do not judge all hospitals by the standards of yours If you feel the nurses have no skills or critical thinking abilities. I seriously doubt this is totally true but more hearsay from the Paramedics around you. You seem to have a very low opinion of nurses now even though you want to be an RN and everything you have posted probably are the words of some Paramedic who feels street smarts trump education. Unless you have respect for nursing as a profession, it will be a waste of time for you and someone who could have had your seat in a nursing program.

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    Wow! Yall's conversation is interesting. If I may give a touch of advice here though. I was a paramedic for 6 years. I have worked rural EMS and private EMS that was mutual aid for the cities and outlaying districts. I have done a little bit of it all in EMS, whether it be organ transplant to emergency care to TAC Air runs (you take a team and pt from a hospital to the airport) to nursing home needs. I graduated as a paramedic with an Associated of Applied Science degree when I was 21. I have been a CNA (did the course my senior year of HS), an EMT-B (finished at 19), an EMT-P (graduated a few months after turning 21) and now I am 3 semesters from obtaining my BSN (I will be 30 when I finish). I also have a 4.0 in all nursing courses and tutor for about 5 different nursing science courses including pathophysiology. I say all that to tell you that I have experience and I can tell you that not many newbie medics have the same critical thinking skills as nurses. Newbie nurses also haven't really developed the skills either. Critical thinking comes from time and experience and mistakes. I know several "old school" medics (folks that were medics when I was born and have the number to prove it) that could out think most doctors. If your ultimate goal is to be a flight nurse, finish your paramedic, do your CEU's, get your BSN and ride out 2-4 times per month to keep your medic up. I personally plan to retake the medic exam once I graduate and that will entail a refresher course, CEU's and retaking the exam. Good luck with whatever you plan to do.

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    • Experts
    TraumaSurfer,

    I think you misinterpeted. I am currently enrolled in a BSN program I only have four more prereqs to do -, and am half done my paramedic program.. I am enrolled in a UNIVERSITY. The ADN is offered through a community college.

    Here the flight paramedics and nurses are expected to perform the same set of skills at the same competency. They are equals. In medic school you are already taught how to intubate (I did my first one 2 days ago). The helicopters here cannot even take off unless a medic is on board and working. The only difference is you need 3 years minimum as a critical care nurse, and 5 years at a busy 9-1-1 service.

    And I think it's just as bad going RN-medic bridge as apposed to Medic-RN. You miss the critical thinking and problem solving that goes into being a medic.

    I plan on getting my BSN eventually, I just was wondering if it would be smart to get my ADN in a year then bridge to my BSN. While working in the ICU gaining experience.

    The service I am taking my medic course through offers perdiem spots 8, 12, 16 and they always have shifts available. My work schedule in not a real issue. All my credits won't expire.

    I dont want this to turn into a debate whether being a nurse is better than a medic. I feel like you dont respect what goes into being a medic. Airway/cardiac specialist and quick decision maker without a doc writing every order for you. I want both, and I think getting my medic will do nothing but help.

    I think you need to listen to traumasurfer. I think you have been talking to paramedics and now you are talking to nurses. I was a flight nurse....who got her paramedic so I was familiar with the state protocols and medical control. So I could learn the street side of patient care. Although I got hired for my extensive emergency department and critical/cardiac care experience I felt there was a piece missing that I needed for me.

    Nurses and paramedics are two completely different disciplines. It is comparing apples and oranges...while they are both fruits they are NOT equal nor the same. If you think that nurses aren't quick

    what goes into being a medic. Airway/cardiac specialist and quick decision maker without a doc writing every order for you.
    decision makers and require a doctors order for decision making in an ICU setting you need some educating about the responsibilities of a critical care nurse. Learning to intubate and look at an EKG is an skill that doesn't require "critical thinking" just like starting an IV.

    I am curious who told you that the helicopter can't take off without a medic. Frankly, the helicopter can't take off without a pilot. The helicopter needs both the medic and the nurse as there are meds that medics cannot give , for they are NOT included in state protocols, and nurses can can give by state protocols and Nurse practice acts.

    Both can intubate and read EKG's.....Both of them need standing orders and medical control for orders although both are very independent and know their jobs. The nurse can perform both job duties... however, the medic cannot perform some of the nurses duties.....if that upsets you I'm sorry. It's the truth. Nurse know PA lines, balloon pumps and various cardiac drips that medics do not and are not allowed to do especially when on the ground or in a facility.

    As a flight nurse you will be responsible for the transport of critical patients with invasive lines, drips, and monitoring that only the ICU nurse will know how to deal with and intervene when necessary.

    Flight nursing requirements very slightly from company to company however, they want ICU experience and emergency department experience. These nurses are highly trained and experienced individuals that are the top of their field. The move is for all entry new grads to have a BSN...while there are AND with experience out there....they are not new grads and their experience gives them the edge. Lifeflight of Maine.....

    Critical Care Transport Nurse

    • Registered Professional Nurse currently licensed in Maine
    • Minimum two years critical care experience required in ICU/CCU/CSU/PICU/NICU demonstrating comprehensive management of the critical care patient
    • Critical care transport experience preferred.
    • CCRN, CFRN or CEN certification preferred prior to hire; must completed within 18 months of hire
    • TNCC required within 6 months
    • Critical care transport experience/flight preferred
    • ACLS and PALS required
    • Positive interpersonal skills
    • Must pass physical agility evaluation
    • Must meet weight restriction (
    • Must successfully complete flight safety and flight physiology courses

    - See more at: Job Listings | LifeFlight

    I think you need to find a flight crew and ask serious questions. If your goal is to be a flight nurse then the BSN ans ICU experience is what you need. If you wish to be a medic then be a medic.

    To take the CCRN you will have to have hours at the bedside to qualify to sit for the exam.

    Initial Eligibility Requirements

    • Current unencumbered licensure as an RN or APRN in the U.S. is required.
      • An unencumbered license is not currently being subjected to formal discipline by any board of nursing and has no provisions or conditions that limit the nurse's practice in any way.

      [*]Candidates must meet one of the following clinical practice requirement options:

      • Option 1: Practice as an RN or APRN for 1,750 hours in direct bedside care of acutely and/or critically ill patients during the previous two years, with 875 of those hours accrued in the most recent year preceding application.
      • Option 2: Practice as an RN or APRN for at least five years with a minimum of 2,000 hours in direct bedside care of acutely and/or critically ill patients, with 144 of those hours accrued in the most recent year preceding application.

      [*]Eligible clinical practice hours are those:

      • spent caring for a single patient population (adult, pediatric or neonatal) matching the exam for which you are applying.
      • spent supervising nurses or nursing students at the bedside, if working as a manager, educator (in-service or academic), APRN or preceptor.
      • completed in a U.S.-based or Canada-based facility or in a facility determined to be comparable to the U.S. standard of acute/critical care nursing practice.

      [*]The name and address of a professional associate must be given for verification of clinical practice.

      • A professional associate is defined as either a clinical supervisor or colleague (RN or physician) with whom you work.

    I think the CCEMTP is a certification program that is required for paramedics to breach the gap of critical care medicine and optional for nurses to help nurses bridge the gap to street medicine.

    Medics know protocols and procedures....nurses know the pathophysiology...together they make a great team.

    So which do you want to be a medic or a nurse? If your answer is nurse...then get your BSN (and I am a ASN to BSN prepared nurse) get a job in ICU get your CCRN and try to get a flight position. Then while you are working as an ICU nurse....look at getting your EMT-P

    That is what I suggest as an ex flight nurse.

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    • Guides

    Wait. You said you were halfway through your BSN program but then said you still have pre-reqs to go?

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    • Experts
    I want to do both. Jack of all trades. I think itd be best to agree to disagree, because I see an RN and EMT-P certification to be very equivalent. I dont down play anything. I know both professions are totally different. One is long term, one is short term. Like I said, in my state they are both equivalent, and a paramedic needs to be able to everything an RN can and vice versa.

    I do believe in education too. I believe in being well rounded too. My goal is to make myself the most competitive applicant. So if I can be competent as both a medic and a nurse it can only benefit me.

    I can see where your dislike for medics are on your previous post. I understand it.

    I believe your answer to my question is stick with the BSN program. CCRN over CCEMT. And I am assuming you are not a medic either so you cannot answer my second question. Thank you for chatting with me :-)

    As a former medic...and a very experienced critical care/emergency medicine RN. A RN with extensive critical care experience and a EMT-P are NOT equivalent in any way shape or form. The state of Maine is NO different.

    My suggestion....become proficient as one first be it RN or Medic but pick one...trying to do it all at once will not benefit you nor make you have an edge as a new grad and get hired on a crew. You will still be a new grad.

    CCRN and CCEMT is once again comparing apples and oranges. If you want to be a nurse CCRN if however you wish to be a medic CCEMT. Very simple.

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    Sorry, not here to offer any advice. I just wanted to say that i applaud you for your ambition at 20 years of age. If you channel your youthful energy and ambition in the right direction- you will be very successful!

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    • Author

    1. Maine Flight Protocols says that a medic has to be on board.

    2. I think that if I work part time as a medic and part time as a nurse it would suffice as me at being profiecient in two job. My original question was not asking if that is okay. It was whether or not to stick through and get my bachelors.

    3. I have a couple undergrad classes to go before I do my 2 year clinical rotation. Which is why I am getting my medic to work as a medic for those 2 years.

    4. As I said before, Here flight medics and nurses are expected to perform at the same level. There is no descripency on who can give what meds and who can do what procedure.

    5. Reading an EKG is an art- It's not just another skill comparing it to just another skill is ignorant. Cardiac is where EMTs and Medics truly make a difference.

    6. My goal is to just get on the flight scene, nurse/medic whatever. My goal is to make it on, and be THE BEST.

    7. You guys are so black and white. You can be both, I know people that do operate as a street medic and a nurse. There is NOTHING wrong with it. Pulling 2-24s and a 16 and 8 is very do able.

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    This is just one good example and reason you will need critical care experience and knowledge as a nurse with future ambitions to being a flight nurse...Managing an intubated patient via bagging and ETCO2/SvO2 monitoring is one thing. Flight nurses and critical care trained paramedics understand the physiology with manage and operating mechanical ventilation. They understand as it relates to flight physiology, blood gases, hemodynamic effects, pharmacological effects, etc.... It is a far cry from just bagging an intubated patient. This is where the ICU experience with critical care thinking comes into play. Since you are close to getting your BSN and looking to take a paramedic course, a good approach towards becoming a flight nurse is to get as much critical care experience and knowledge as an RN and perhaps do some part time shifts on and ALS ground unit as a paramedic. After at least 3 years critical care experience preferably in ICU, CCU and additional time with acute care in the ED along with your paramedic experience you will then be very marketable when applying for a flight nurse position. Best of luck in your future endeavors!!

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    • Experts
    1. Maine Flight Protocols says that a medic has to be on board.

    2. I think that if I work part time as a medic and part time as a nurse it would suffice as me at being proficient in two job. My original question was not asking if that is okay. It was whether or not to stick through and get my bachelors.

    3. I have a couple undergrad classes to go before I do my 2 year clinical rotation. Which is why I am getting my medic to work as a medic for those 2 years.

    4. As I said before, Here flight medics and nurses are expected to perform at the same level. There is no discrepancy on who can give what meds and who can do what procedure.

    5. Reading an EKG is an art- It's not just another skill comparing it to just another skill is ignorant. Cardiac is where EMTs and Medics truly make a difference.

    6. My goal is to just get on the flight scene, nurse/medic whatever. My goal is to make it on, and be THE BEST.

    7. You guys are so black and white. You can be both, I know people that do operate as a street medic and a nurse. There is NOTHING wrong with it. Pulling 2-24s and a 16 and 8 is very do able.

    Reading an EKG is a skill....knowing why those changes are there, what coronary artery is affected, and how does this impact your patients care.... is the art. I'm the one that made that statement....so I'm ignorant? Really.....? Okay. Your choice.

    You are young and a student...Clearly your mind is made up. At 20yrs old that it quite a feat. Good for you. I have been an RN since I was 18, soon to be 50 mumble mumble....so I know all about knowing what you want. I have been a this a LONG TIME! I'm glad you feel you know better. Confidence can be a good thing but it can also be a dangerous flaw.

    No Offense...I know Maine and paramedics do not deal with PA lines nor balloon pumps. Could you please cite the source for your information that paramedics are the equals of RN's and perform the same duties as well as a medic must be on board to fly? They need a full crew to fly depending on the call and service supplied it is both a medic and a nurse as well as the pilot/co-pilot

    However in Maine there is a requirement that a inter-facility transport medic complete the PIFT course and accreditation.

    This specifically lists the responsibilities/scope of practice of the medic and the medics limitations to include that a EMT-P/PIFT CANNOT monitor for transport. http://www.maine.gov/ems/documents/IFTDecisionTree.pdf

    Items that MAY NOT be transported by Maine EMS Providers without additional staff (RN,RT,etc)

    -Ventilators

    -Blood Products Anesthetic agents(i.e.propofol)

    -Medication classes not listed on the MEMS formulary or PIFT list

    -Other specialty devices not approved for the PIFT program by Maine EMS and the MDPB

    So...you need a nurse.

    The nurse and medic are two different roles each compliments each other but they are very different. If you choose to follow your own path that is your choice experienced flight nurses have shared their opinion and thoughts...whether you choose to use it is entirely up to you.

    For your reading leisure to make a more informed decision....the PIFT manual.

    http://www.maine.gov/ems/documents/PIFTInstructorManual.pdf

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    1. Maine Flight Protocols says that a medic has to be on board.

    2. I think that if I work part time as a medic and part time as a nurse it would suffice as me at being profiecient in two job. My original question was not asking if that is okay. It was whether or not to stick through and get my bachelors.

    3. I have a couple undergrad classes to go before I do my 2 year clinical rotation. Which is why I am getting my medic to work as a medic for those 2 years.

    4. As I said before, Here flight medics and nurses are expected to perform at the same level. There is no descripency on who can give what meds and who can do what procedure.

    5. Reading an EKG is an art- It's not just another skill comparing it to just another skill is ignorant. Cardiac is where EMTs and Medics truly make a difference.

    6. My goal is to just get on the flight scene, nurse/medic whatever. My goal is to make it on, and be THE BEST.

    7. You guys are so black and white. You can be both, I know people that do operate as a street medic and a nurse. There is NOTHING wrong with it. Pulling 2-24s and a 16 and 8 is very do able.

    1. That depends upon the team. Specialty teams which flight do not require a Paramedic since their services require more expertise in a certain area such as ECMO, Neonatal or Pediatric.

    Throughout the US other crew configurations are used. RN/RN is very popular. There are also a few RN/RT teams which do scene response.

    You should also read the link posted by Esme12 about the regulations and what the Paramedic can not do by limitations in their scope of practice which is why an RN and/or RT is needed as a team member.

    2. If you can't find a job with just the ADN, then the working part as an RN is a moot point.

    3. No clue why you are stalling on the classes for nursing.

    4. That would also depend on the service and maybe the limitations of the service. Not all HEMS are created equal especially if they only do scene response and no critical care IFT.

    5.

    Reading an EKG is an art- It's not just another skill comparing it to just another skill is ignorant. Cardiac is where EMTs and Medics truly make a difference.

    This one you need to explain yourself. Did you know that almost 50% of the ALS trucks in the US do not do 12 lead EKGs? 12 Leads are not taught in EMT curriculums. Many in EMS view this as just another "skill". Except for doing one, what are you going to do to treat the patient. You could transmit the EKG to a physician but not all ambulances are equipped to do this.

    Why is doing an EKG different than how you have perceived intubation to be? You have already done an intubation but you have only started your Paramedic class. You still have a lot to learn about intubation and intubated patients. I will argue that EKG is not an art. It does takes some education and experience to master this skill.

    Early CPR makes a difference and this includes bystanders. The reason Seattle is so successful is because of the large effort to educate the public about CPR.

    Do you believe that nurses who do work with EKG monitors (telemetry) and perform EKGs don't make a difference? EMTs and Paramedics are reporting their findings also directly to a physician. EMTs and Paramedics activate the cath lab only if the physician is in agreement.

    6. To be the best at something you need to get experience with it. Since you were an EMT in the ER, you probably have very little ambulance time. You are torn between two professions which have very different scopes of practice and goals. You are having a difficult time separating these two in your posts. Unless you fully understand one, this blending will continue and you will have a difficult time as a newbie in both professions.

    7. It is called burn out. You also don't know how many times you will be mandated to do OT on an ambulance at the end of a shift. You can not just walk away from a patient in an ambulance. This might put you with very little sleep. Mistakes at this level of responsibility (RN or Paramedic) kill patients. If you work for a very slow EMS service, the advantage is you will sleep but you also will not be getting much experience as a Paramedic.

    You should listen to those who have been both even if they work as RNs.

    This all might sound harsh but it is pretty obvious that you are leaning more toward EMS and are dismissing any value RNs have. Again I have to ask why you want to be an RN? You seem to not want to know what they can do and have argued they can not do it as well as an EMT or Paramedic throughout much of this discussion. Links have even been provided to show you the differences RNs make in MAINE on a flight team and the state regulations which go along with it. You again seem to be hearing only one side.

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